Clonidine Clonidine is a non stimulant medication frequently used for treatment of chronic motor tic disorders and Tourette Syndrome, and also for ADHD with or without tics, where stimulant medication is not tolerated or effective. In particular it can be helpful if there is a sleep disorder either as part of the ADHD or as a response to stimulant treatment. It is also sometimes useful in children with autistic spectrum disorders where there are problems such as hyperactivity or aggression. It is not licensed for use in ADHD, Tourette's or tics. There are tablet preparations, Dixarit 25micrograms and Catapres 100 & 300 micrograms (a microgram is 1/1000 of a milligram) Treatment Protocol Starting dose 25 micrograms once daily Increase by 25 micrograms every 4-7 days Schedule for ADHD or tics sleep twice or three times daily once before bedtime Usual effective dose for ADHD or tics for sleep 50-75 micrograms minimum of 50 micrograms Maximum daily dose 300 micrograms per day Start with 25 micrograms in the morning and observe for effect or side effects. After 1 week, if necessary, increase this dose to 50 micrograms. After 1 week add a second dose early evening. If needed, three doses a day can be given. Some immediate effects are seen but usually there is also a slow improvement over a month or so. For sleep management, start as above with 25 micrograms. Increase by 25 microgram increments every week until desired effect is achieved. The total dose must be discussed at each stage with your Consultant. Monitoring Your child will have his/her blood pressure, heart and pulse examined at the beginning of treatment. The frequency or severity of the symptoms will be monitored and with each significant increase in dose blood pressure and pulse are monitored. Do not suddenly withdraw treatment given regularly throughout each day, as this may cause a withdrawal syndrome (see below) More common reported side effects Drowsiness or sedation, dizziness on standing (due to low blood pressure) Less common reported side effects Headache, nausea or vomiting, weakness or fatigue, restlessness at night or vivid dreams Withdrawal syndrome (seen if treatment is suddenly stopped) Hypertension, restlessness, anxiety, tremor, palpitations, abdominal or muscle pain Acknowledgement to Dr D Keen